AB0773 Serum VEGF level may be have a role in the evaluation of treatment response and disease activity during TNFi therapy in patients with AxSpA
Authors: M. Gulec Yazir, E. Durak Ediboglu, G. Alp, H. Cinakli, İ. Kurut Aysin, E. Erpek, E. Otman Akat, S. Gucenmez, M. Ozmen, S. Ketenci, O. Bayindir, D. Solmaz, S. Akar
Journal: Annals of the Rheumatic Diseases (2022)

Background Patient reported outcomes (BASDAI and BASFI) are used to evaluate disease activity in axial spondylarthritis (axSpA), however, apart from C-reactive protein (CRP) there are no widely used serum biomarkers to assess disease activity and treatment responce. Objectives In this study, we aimed to evaluate the relationship between serum biomarkers (serum leptin, VEGF, MMP-3) and disease activity as well as the changes of those biomarker levels during TNFi treatment. Methods Patients with axSpA who put on their first TNFi and had serum samples at baseline and 6 th month of therapy were included in the analysis The demographic, clinical and laboratory characteristics disease activity and function parameters (BASDAI, BASFI, ASDAS-CRP, serum CRP levels) at baseline and 6 th months were recorded. Levels of serum leptin, VEGF and MMP-3 were studied by ELISA method. The relationship between serum biomarkers and disease activity scales in addition CRP levels were tested by correlation analysis. The factors affecting the change in seruml biomarkers level in 6 th month were also analyzed by GEE which is a longitudanal analysis method. Results A total of 74 patients (mean age (SD) 48.7 (12.8) years, 54.1% male, 68.9% with AS) were included in this study. Baseline median BASDAI scores (IQR) were 5.8 (2.4), ASDAS scores (IQR) 3.7 (1.5) and median CRP levels (IQR) 12 (23). Disease activity parameters (BASDAI, BASFI, ASDAS-CRP) were significantly decreased at 6 th month of therapy (p&lt;0,001, p&lt;0,001, p&lt;0,001, respectively). The correlation between baseline serum biomarker levels (leptin, MMP3, VEGF) and between biomarkers level and disease activity were eveluated and only serum MMP-3 levels were found to be associated with baseline ASDAS-CRP (p=0.02). Serum VEGF level decreased significantly compared to the baseline at the 6 th month of TNFi treatment (p&lt;0.001), however, serum leptin and MMP-3 levels were not associated with disease activity and affected by biologic treatment (p=0.89, p=0.50, respectively). In the longitudinal analysis, serum VEGF level were significantly associated with gender, hip involvement, delay in diagnosis in addition to disease activity (Table 1). Table 1. The factors associated with serum VEGF levels longitudinally Univariate analiz BASDAİ+CRP Model ASDAS -CRP Model B (%95 CI) p B (%95 CI) p B (%95 CI) p Hip involvement 181.74 (12.71- 350.77) 0.035 357.04(112.35- 601.73) 0.04 338.36 (102.40-574.3) 0.005 Duration of delay in diagnosis -6.91 (-14.05- 0.24) 0.058 -13.93 (-24.56 to -3.31) 0.01 -14.36 (-24.68 to -4.03) 0.006 Gender -216.88 (-390.6 to -43.2) 0.014 -154.23 (-336.94- 28.48) 0.09 -162.6(-336.70- 11.4) 0.006 HLA-B27 positivity -233.4 (-440.67 to -26.11) 0.027 -135.78(-326.08- 54.52) 0.16 -126.54(-309.2- 56.1) 0.17 BASDAI 4.12 (1.06- 7.18) 0.008 5.60 (2.16- 9.05) 0.001 ASDAS-CRP 110.04 (58.18- 161.88) &lt;0.001 132.31(74.70- 189.92) &lt;0.001 Serum CRP level 5.86 (1.02- 10.7) 0.018 4.09 (-0.99- 9.183) 0.11 Conclusion TNFi treatment is not only effectively control disease activity but also cause significant decrease in serum VEGF levels in patients with axSpA. Considering the role of VEGF in radiographic progression it could be a promising biomarker in axSpA Disclosure of Interests None declared